She said, he said: Discrepancies between Females and Males in Reproductive Health Knowledge, Attitudes, and Behavior in a Traditional Community in Rural Western Kenya
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East Africa carries the highest burden of unplanned pregnancy worldwide. The Luo tribe of western Kenya additionally faces the highest rates of adolescent pregnancy, infant mortality, maternal mortality, and HIV transmission in Kenya. This region also claims the highest unmet need for family planning globally, and, even where family planning services are available, they remain underutilized. Though numerous studies have been conducted regarding women’s views and behaviors in regards to the poor maternal and child health in this region, the male perspective has been nearly entirely absent from this dialogue until recently. There is a particular dearth of research regarding the similarities and differences between male and female knowledge, attitudes, and behaviors regarding reproductive health. This study is a secondary analysis of data from two prior cross-sectional studies of the self-report of 112 Luo women and 50 Luo men from rural Kenya regarding reproductive health, family planning, and sexually transmitted diseases. Despite Luo women being regarded as the essential source of all health information for their community, results showed that only 8% of women had even a basic knowledge of reproductive health, in surprising contrast to 36% of the men. In addition, both men and women stated that husbands and wives primarily consult one another in order to make family planning decisions, however they were also found to have discordant cultural beliefs regarding appropriate family size, family planning methods, forced sex, and HIV/AIDS prevention. These findings highlight the complexity of implementing change in sexual and reproductive health behavior in traditional, resource-poor communities, and future initiatives will need to address both a lack of knowledge and differing cultural beliefs between men and women.